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91. Incentives in China's Healthcare Delivery System

Author:
Karen Eggleston
Publication Date:
10-2008
Content Type:
Working Paper
Institution:
Walter H. Shorenstein Asia-Pacific Research Center
Abstract:
The economic approach of comparative and historical institutional analysis (Aoki 2001, Greif 2006) has virtually never been used in theoretical studies of healthcare incentives. This paper seeks to help fill this gap by exploring the explanatory power of such an approach for understanding incentives in China's healthcare delivery system. It focuses on positive analysis of why China's health system incentives evolved the way they did. The first section analyzes the institution of physician dispensing (MDD) and reforms toward separation of prescribing from dispensing (SPD), in historical and comparative perspective. It shows, for example, how MDD was a self-reinforcing institution; the longer a society remains under MDD, the higher the associated costs of supplier-induced demand can be before implementing SPD becomes the efficient self-enforcing social institution. Rapid technological change and adoption of universal coverage are likely to trigger SPD reforms. The second section seeks to explain the pattern and impact of price regulation and hospital payment reforms in contemporary China, which also reflect the legacy of MDD.
Topic:
Government, Health, and Human Welfare
Political Geography:
China, Israel, and Asia

92. The Effect of Informal Caregiving on Labor Market Outcomes in South Korea

Author:
Young Kyung Do
Publication Date:
12-2008
Content Type:
Working Paper
Institution:
Walter H. Shorenstein Asia-Pacific Research Center
Abstract:
Embedded in traditional culture perpetuating family-centered elderly care, informal care is still viewed as a family or moral issue rather than a social and policy issue in South Korea. Using newly available micro data from the Korean Longitudinal Study of Aging, this study investigates the effect of informal caregiving on labor market outcomes in South Korea. By doing so, this study provides evidence to inform elderly long-term care policy in South Korea, and also fills a gap in the international literature by providing results from an Asian country. Empirical analyses address various methodological issues by investigating gender differences, by examining both extensive and intensive labor market adjustments with two definitions of labor force participation, by employing different functional forms of care intensity, and by accounting for the potential endogeneity of informal care as well as intergenerational co-residence. Robust findings suggest negative effects of informal caregiving on labor market outcomes among women, but not among men. Compared with otherwise similar non-caregivers, female intensive caregivers who provide at least more than 10 hours of care per week are at an increased risk of being out of the labor force by 15.2 percentage points. When examining the probability of employment in the formal sector only, the effect magnitude is smaller. Among employed women, more intensive caregivers receive lower hourly wages by 1.65K Korean Won than otherwise similar non-caregivers. Informal care is already an important economic issue in South Korea even though aging is still at an early stage.
Topic:
Demographics, Health, and Markets
Political Geography:
Israel, Asia, and South Korea

93. HIV/AIDS: The looming Asia Pacific pandemic

Author:
Bill Bowtell
Publication Date:
03-2007
Content Type:
Policy Brief
Institution:
Lowy Institute for International Policy
Abstract:
The international effort to control the spread of the HIV pandemic is failing: new HIV caseloads are rising alarmingly in many parts of the Asia Pacific. For over 20 years we have known how to prevent the transmission of the HIV virus by persuading young people to make simple and sustainable changes in sexual practices and other risky behaviours. Yet despite the scientific evidence, many national governments are unable or unwilling to act in time to avert the problem.
Topic:
HIV/AIDS and Health
Political Geography:
Asia and Australia/Pacific

94. The World is Still Waiting: Broken G8 promises are costing millions of lives

Publication Date:
05-2007
Content Type:
Policy Brief
Institution:
Oxfam Publishing
Abstract:
Poverty and suffering could be ended in our lifetime, and our leaders must do everything in their power to make this happen. This was the clear demand of the 40 million people in 36 countries who took part in the Global Call to Action Against Poverty in 2005. A year later, in the space of just one day, 24 million people across the world stood up against poverty as part of World Poverty Day.
Topic:
Education, Health, and Poverty
Political Geography:
Russia, United States, Japan, United Kingdom, Europe, Canada, Asia, France, Germany, and Italy

95. Interview with Thai Health Minister Mongkol Na Songkhla

Author:
Nermeen Shaikh
Publication Date:
05-2007
Content Type:
Working Paper
Institution:
Asia Society
Abstract:
Mongkol Na Songkhla is the Minister of Public Health in Thailand. He has served in the Ministry of Public Health since his appointment on October 9, 2006. Dr. Mongkol Na Songkhla spoke with Asia Society's Nermeen Shaikh during a visit to New York where he joined a press conference with President Bill Clinton and the Clinton Foundation to announce a global pooled procurement of anti-retroviral drugs.
Topic:
HIV/AIDS, Government, and Health
Political Geography:
New York, Asia, and Thailand

96. Public Health and Conflict Series: Rebuilding a Nation's Health in Afghanistan

Author:
Sarah Dye
Publication Date:
05-2007
Content Type:
Policy Brief
Institution:
United States Institute of Peace
Abstract:
Since the Soviet invasion of 1979, Afghanistan's health system has been decimated by over 27 years of near constant conflict. The ensuing civil war between warlords and rebel groups, including the Taliban, led many Afghan doctors and other intellectuals to flee to Pakistan, Iran, and elsewhere. Under Taliban rule in the 1990s, women were forbidden to attend school, and university teaching hospitals had no equipment, no training materials, and few books. While there have been advances over the past five years through the assistance of United Nations organizations and the international NGO community, Afghanistan's health indicators remain among the lowest in the world.
Topic:
Conflict Resolution and Health
Political Geography:
Afghanistan and Asia

97. Performance-Based Incentives for Health: A Way to Improve Tuberculosis Detection and Treatment Completion?

Author:
Rena Eichler, Diana Weil, and Alexandra Beith
Publication Date:
04-2007
Content Type:
Working Paper
Institution:
Center for Global Development (CGD)
Abstract:
Tuberculosis is a public health emergency in Africa, Eastern Europe, and Central Asia. Of the estimated 1.7 million deaths from TB, 98 percent are in the developing world, the majority being among the poor. In order to reach the MDG and the Stop TB partnership targets for 2015, TB detection rates need to double, treatment success rates must increase to more than 7075 percent, and strategies to address HIV-associated TB and multi-drug resistant TB must be aggressively expanded. DOTS, the internationally-recommended TB control strategy is the foundation of TB control efforts worldwide. A standard recording and monitoring system built on routine service-based data allows nearly all countries in the world to track progress in case detection and treatment completion through routine monitoring. This provides a good base for measuring the impact of different strategies for improving TB control outcomes.
Topic:
Health, International Organization, and Poverty
Political Geography:
Africa, Europe, and Asia

98. Myanmar: New Threats to Humanitarian Aid

Publication Date:
12-2006
Content Type:
Policy Brief
Institution:
International Crisis Group
Abstract:
The delivery of humanitarian assistance in Burma/Myanmar is facing new threats. After a period in which humanitarian space expanded, aid agencies have come under renewed pressure, most seriously from the military government but also from prodemocracy activists overseas who seek to curtail or control assistance programs. Restrictions imposed by the military regime have worsened in parallel with its continued refusal to permit meaningful opposition political activity and its crackdown on the Karen. The decision of the Global Fund for AIDS, Tuberculosis and Malaria to withdraw from the country in 2005 was a serious setback, which put thousands of lives in jeopardy, although it has been partly reversed by the new Three Diseases Fund (3D Fund). There is a need to get beyond debates over the country's highly repressive political system; failure to halt the slide towards a humanitarian crisis could shatter social stability and put solutions beyond the reach of whatever government is in power.
Topic:
Government, Health, and Humanitarian Aid
Political Geography:
Asia and Myanmar

99. Food Security in North Korea: Designing Realistic Possibilities

Author:
Randall Ireson
Publication Date:
02-2006
Content Type:
Working Paper
Institution:
Walter H. Shorenstein Asia-Pacific Research Center
Abstract:
Between about 1990 and 1996, North Korea experienced what can only be described as a catastrophic economic collapse, which included a 70 percent reduction in food production compared to the late 1980s. The Democratic People's Republic of Korea (DPRK) initially insisted that the agriculture collapse was a consequence of natural disasters. However, it is clear that the seeds of this catastrophe had been planted decades earlier, the result of ill-advised and ultimately unsustainable national agricultural policies. Yet difficult as the situation is, it is not without options for significant improvement. This paper outlines a strategy for agricultural revitalization in North Korea, which could, in the foreseeable future, enable the DPRK to produce—domestically and in a sustainable manner—nearly all the food needed to supply a basic balanced diet for its population. Whether this strategy can be implemented, or indeed whether it is the best strategy for the DPRK in the longer term, depends on many factors outside the farm sector, including world and regional international political issues, and DPRK policy choices regarding participation in world trade and commerce.
Topic:
International Relations, Government, Health, and Human Welfare
Political Geography:
Asia, North Korea, and Korea

100. National Food Policies Impacting on Food Security: The Experience of India, a Large Populated Country

Author:
S.S. Acharya
Publication Date:
07-2006
Content Type:
Working Paper
Institution:
United Nations University
Abstract:
India accounts for 16.7 per cent of the world's food consumers. With the exception of China, India's size in terms of food consumers is many times larger than the average size of the rest of the countries. At the time of independence in 1947, India was in the grip of a serious food crisis, which was accentuated by the partition of the country. The demand for food far exceeded supply, food prices were high and more than half of the population living below the poverty line with inadequate purchasing power. With high rates of population growth, the dependence on imported food increased further. However, the situation improved considerably after the mid-1960s, when new agricultural development strategy and food policies were adopted. The production of staple cereals increased substantially, mainly contributed by productivity improvements. The dependence on food imports decreased and the country became a marginal net exporter of cereals. There was also an improvement in physical and economic access of households to cereals and other nutritive food products. The proportion of households reporting hunger went down and the incidence of economic poverty reduced. This paper reviews the Indian approach to tackling the severe problem of food insecurity, which India faced immediately after independence. It reviews the evolution of food policy, the major policy instruments deployed, intervention in food marketing system, and the current status of food security/insecurity. The paper also identifies the lessons emerging from the experience of India. In developing countries characterized by large segments of the rural population dependent on food production for livelihood and by the high incidence of poverty, food insecurity and malnutrition, the strategy to improve food security must encompass programmes to increase food production that combine improved technology transfer, price support to food producers and supply of inputs at reasonable prices to farmers, improvements in food marketing system, employment generation, direct food assistance programmes, and improvement in the access to education and primary health care.
Topic:
Health and Human Welfare
Political Geography:
China, India, and Asia